Explanation and Guide
Form: Purpose: Stock Assignment Separate From Certificate (Form 5.6) This is a sample form to transfer stock held in a private company to another party. Note that a separate agreement for the sale or transfer of the stock may be appropriate
STOCK ASSIGNMENT SEPARATE FROM CERTIFICATE
FOR VALUE RECEIVED [and pursuant to that certain Agreement dated ___________, 199_], the undersigned hereby sells, assigns and transfers unto _________ [Number of Shares (#)] [Common] Shares of [Name of Corporation], a ____________ corporation, standing in the undersigned’s name on the books of said corporation represented by Certificate No. ____ herewith, and does hereby irrevocably constitute and appoint ______________________ attorney to transfer said stock on the books of said corporation with full power of substitution in the premises.
Dated: __________, 199_
Signature: [Name of Shareholder]